TDC: Law and Ethics Exam

Standard of Care

The usual standard or consensus on what is customary practice in a given field

In other words, what other therapists are doing and agree upon

Standard of Care and making decisions

Standard of care is an overarching guide to make decision in the benefit of the client and safety

Tip* for the exam: The right answer would always be areas that protect the client and not what areas would make life easier for thp

Consultation and Standard of Care

A good way to see if you're abiding by standard of care is through consultation

Standard of Care legal or ethical?

Both, it is continually changing as well

Scope of practice (legal or ethical)?

Legal issue

Scope of practice

Procedures, Processes, and actions that are permitted for an individual license in a given field

This dictates what a MFT can do. What you're allowed to do under the MFT license

E.g., Psychotherapy is within the scope of practice, but not for a massage thp

Scope of practice is a Legal issue

Scope of competence (legal or ethical)

Ethical

Scope of Competence

It defines the area of practice within a field to which an individual is proficient to work in

Something within your skillset

E.g., Eating disorders would be outside my scope of competence because I don't have the skills to work with them

Self Determination and Autonomy

We want to support clients in their agency in making decisions about their own life

We want clients to have more ability to make decisions for their own self.

Therapists should not tell clients what to do

What overrides self-determination?

Safety

E.g., Therapist would intervene in clt's wishes to prevent suicide

Informed Consent

Clients have the right to know in advanced the procedures, relevant facts, and risks.

Whoever is giving consent must be in sufficient mental capacity to consent for treatment

When should informed consent take place?

Informed consent should take place at the onset of therapy (prior to the onset of therapy)

Adults and written informed consent

With an adult you don't need written informed consent, but at least document

It is best practice to get written consent

Legal Requirements for informed consent

1) Fees of services

2) License Status

3) If there is technology utilization

4) HIPAA privacy rights

5) Where complaints can be filed

6) If there is a factitious business name, name licensed owner

Informed Consent with Minors

Must be signed in writing

Minors who can consent for treatment on their own

If a minor is 12 years or older, is deemed mature enough, and has a good reason to seek out tx, then they can consent for tx on their own

Parents signing consent for treatment

If parents are married either parents can consent for treatment

If they've never been married either parent can consent for treatment

Divorced Parents

If divorced, you must look at custody aggreement to see who has legal custoday. If both have custody, depending on the custody agreement both need to sign. If the custody agreement doesn't say, the best pracitce is to have both of them sign, but you are not required to do so

Standard of Care requirement for informed consent

1)Limits to confidentiality

2) Risks of treatment

3) Benefits of treatment

4) Alternatives to treatment

5) Background of thp

6) Right to refusal

7) Cancellation Policies

Parent with sole legal custody

If a parent has sole legal custody, then the parent who has sole legal custody must consent for treatment and the other parent cannot.

Legal Guardian

That person may consent for treatment

Caregiver's Affadavid: If parents are missing, and there is someone else watching over the child they can sign a

Caregiver affadavid is their caregiver

Foster Child Consent for Treatment

If a child is in foster care, the child's lawyer must consent for treatment, unless the court has issued a minute order for social worker or foster parent to consent

Couples or families informed consent

"No Secrets Policy" should be included in informed consent

Groups with informed consent

Other members of the group are not required to keep things confidential

Let the members of the group know that this is a risk and they wouldnt be able to sue other members if they blabbed

If confidentiality within a group therapy group has been breached?

You want to direct the person to bring the issue up in the group session.

As the leader you would help facilitate that discussion but you would not want to be the one who brings it up as it would indicate that the leader has had outside discussions with a group member

Situations Where You can treat without informed consent

1) Crisis situation

2) When a clt refused informed consent - but you would want to document that you made an attempt to get informed consent

Engaging in experimental treatment

You'd want to have signed infrmed consent of the risks

E.g., EMDR

Parents and access to their children's records

If a Clt child is 12 years or older, the clt must given written authorization to allow anyone to access their records

What are the legal requirements you must abide by to treat minor who's parents aren't in the treatment process?

You need to have a justifable reason why parents aren't in treatment process and document it.

You should first figure this out before obtaining written consent for treatment from the client

What should you do if a clt wants services outside your scope of competence?

Provide them with resource to someone within that scope of competence